{"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"}}]}],"in_network":[{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9145","name":"Insulin pump initiation","description":"Insulin pump initiation, instruction in initial use of pump (pump not included)","date_of_service":"2026-05-23","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99601","name":"Home nfs visit <2 hrs","description":"Home infusion/specialty drug administration, per visit (up to 2 hours);","date_of_service":"2026-05-23","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9351","name":"Hit cont antiemetic diem","description":"Home infusion therapy, continuous or intermittent anti-emetic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and visits coded separately), per diem","date_of_service":"2026-05-23","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9214","name":"Hm gest dm per diem","description":"Home management of gestational diabetes, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately); per diem (do not use this code with any home infusion per diem code)","date_of_service":"2026-05-23","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9379","name":"Hit noc per diem","description":"Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-05-23","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9213","name":"Hm preeclamp per diem","description":"Home management of preeclampsia, includes administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing services coded separately); per diem (do not use this code with any home infusion per diem code)","date_of_service":"2026-05-23","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9560","name":"Ht inj hormone diem","description":"Home injectable therapy; hormonal therapy (e.g.; leuprolide, goserelin), including administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-05-23","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9123","name":"Nursing care in home rn","description":"Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)","date_of_service":"2026-05-23","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9353","name":"Hit cont insulin diem","description":"Home infusion therapy, continuous insulin infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-05-23","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S9376","name":"Hit hydra 3 liter diem","description":"Home infusion therapy, hydration therapy; more than two liters but no more than three liters per day, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem","date_of_service":"2026-05-23","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]}]}